(Disclaimer: This article is for scientific purposes only. To protect patient privacy, relevant information in the following content has been processed) Abstract: Thyroid nodules, as the disease progresses, may cause enlargement of the thyroid gland, resulting in nodular goiter. Nodular goiter can present with compression of the airway and retrosternal goiter if symptoms are severe. Early detection by ultrasound and timely intervention are needed to avoid serious consequences of delayed treatment. In this article, the patient was found to have untreated thyroid nodules, and later found to have nodular goiter, which was treated with surgery + medication with good therapeutic effect and greatly improved the quality of life. 【Basic information】 Female, 81 years old 【Disease type】 Thyroid nodule, nodular goiter 【Hospitalization】 Jinzhou City Central Hospital 【Date of consultation】 May 2020 【Treatment plan】 Surgery (bilateral thyroidectomy) + medication (levothyroxine sodium tablets) 【Therapy cycle】 Hospitalization for 14 days, followed by follow-up one month later. Treatment result] Bilateral enlarged thyroid glands were surgically resected, and the patient recovered well after the surgery. The patient was found to have thyroid nodules 30 years ago during an ultrasound examination of the thyroid gland, without any treatment at that time and without regular review of the ultrasound examination. 10 years ago, the patient underwent ultrasound examination because of the enlargement of the neck, suggesting a nodular goiter, which was not treated. In the past year, the neck enlargement gradually worsened, and there were symptoms of dyspnea when lying down at rest. In order to seek further treatment, the patient came to the clinic, and the patient perfected the ultrasound examination of the thyroid gland, and the results suggested that there were multiple thyroid nodules bilaterally, and the thyroid gland was enlarged. The patient was admitted to the hospital for treatment, and was admitted as an outpatient with nodular goiter. The patient had no hoarseness, choking on drinking water, etc., and was healthy in general, with no history of hypertension, coronary heart disease, diabetes mellitus, etc. On examination of the neck, the bilateral goiter was palpable and painless, with a size of about 15.0×10.0 cm on the left side and about 12.0×10.0 cm on the right side, and the airway was shifted to the right. After the patient was admitted to the hospital, the routine admission examination was completed, including routine blood test, electrocardiogram, coagulation function, biochemistry, six items of thyroid function, blood type, thyroid static imaging, chest CT and other related examinations. The results of thyroid static imaging suggested that the patient’s two sides of the retrosternal thyroid enlargement, and the patient was operated under general anesthesia for bilateral thyroidectomy after 2 days, and the intraoperative frozen pathology examination suggested benignity. After awakening from anesthesia, the patient returned to the ward, and appropriate nebulized inhalation was given to help the patient to expel sputum after the operation. On the 4th day after the operation, the pathological results of the examination were returned as nodular goiter, and on the 7th day after the operation, the patient recovered well, and the incision was made to remove the nails. After 14 days of hospitalization, the patient was discharged from the hospital with good condition and no discomfort. 1 month later, outpatient review of the thyroid function test showed good recovery, and the dosage of medication was adjusted. The patient was admitted to the hospital for surgery to remove the bilateral thyroid glands, which relieved the patient’s symptoms of airway compression for many years and greatly improved the patient’s quality of life. The surgical process went smoothly, no nerve damage and other related complications occurred, and the postoperative effect was good, with smooth breathing, normal articulation and swallowing function when lying down at rest. However, due to the bilateral thyroidectomy, it was necessary to take levothyroxine sodium tablets orally at regular intervals to help replenish thyroxine, and to adjust the medication according to the results of the thyroid function. Precautions The patient recovered well after surgery and was truly happy for him. However, after discharge from the hospital, the patient should pay more attention to rest, eat more fresh vegetables and fruits, and strengthen nutrition, and eat less food with high iodine content, such as kelp and seaweed. Usually, they should avoid anger and keep a happy mood. After the operation, the thyroid function test should be reviewed regularly to adjust the dosage of Eugenol, and the medication must be taken on time to avoid forgetfulness which may lead to hypothyroidism and other conditions, and the ultrasound of thyroid gland and other tests should be reviewed regularly. Normally, you can strengthen your body and do some exercises to improve immunity and help the postoperative recovery. If you feel unwell, you should consult the doctor and get treatment in time. V. Personal perception Thyroid nodules are relatively common diseases, so if the test results suggest the presence of thyroid nodules, we must pay attention to it, regular review and follow-up, choose drug treatment or surgical resection. If thyroid nodules are left untreated or not regularly reviewed, nodular goiter may occur, or even cancerous, resulting in metastasis, etc., and even the opportunity for surgical treatment may be lost, resulting in irreversible consequences. Therefore, thyroid nodules should be taken seriously. It should be noted that sometimes thyroid nodules may be asymptomatic and easily overlooked, so regular medical checkups for thyroid ultrasound should be done for early detection and treatment.